Plugging of the femoral canal has been advocated in the last few years in total hip arthoplasty. A complication of total hip arthroplasty has commonly been the loosening of the femoral component. A factor which contributes to this is the failure between the bone/cement interface. It has been shown that some type of plugging of the canal prevents the extension of the bone cement beyond the point where it is useful and it also creates a closed space which facilitates more complete filling of the femoral canal. Once the canal is plugged, the canal is filled completely and efficiently with acrylic cement (bone cement). Then the stem of the prosthesis is inserted into the cement filled canal. Due to the closed space, there is a rise in pressure in the acrylic cement during stem insertion, which enhances a stronger cement/stem interface and also enhances a stronger cement/bone interface because the higher pressure forces cement to penetrate the interstices of the bone.
A variety of techniques have been advocated in blocking off the femoral canal, including a bolus of doughy cement, a plug cut from bone which has usually been resected from the femoral head or neck at the time of surgery, an inflated balloon, and a plastic plug. In any case, the material must be a bio-compatible material.